Rehabilitation protocol
Biceps Tenodesis Rehabilitation Protocol
The current rehabilitation protocol used after an isolated primary biceps tenodesis. Because the tenodesis must be protected before the biceps is loaded, early recovery is protective and progression is criteria-based. Your surgeon and physical therapist will tailor it to you — always follow the individualized plan they give you, and use only the protocol your surgical team selected.
Who this protocol is for
Applies to an isolated primary biceps tenodesis, performed either arthroscopically or open-assisted, including a primary tenodesis performed for a proximal long-head rupture. It does NOT apply to a tenotomy, a revision, a reconstruction, a fixation failure, a fracture, a rotator-cuff repair, a labral repair, a shoulder stabilization, or any other concurrent procedure — those cases follow a different, surgeon-selected plan. When a biceps tenodesis is performed together with a rotator-cuff repair, rehabilitation follows the applicable rotator-cuff repair protocol unless the surgeon specifies otherwise. The operative note and surgeon-selected protocol take precedence, and patients should use only the protocol identified by their surgical team.
What this protocol covers
- Rehabilitation after an isolated primary biceps tenodesis — arthroscopic or open-assisted, including a primary tenodesis performed for a proximal long-head rupture — where the tenodesis is protected before the biceps is loaded.
- It does NOT apply to a tenotomy, or to a revision, reconstruction, fixation failure, fracture, rotator-cuff repair, labral repair, shoulder stabilization, or any other concurrent procedure — those follow a different, surgeon-selected plan.
- When a tenodesis is done with a rotator-cuff repair, rehabilitation follows the applicable rotator-cuff repair protocol unless the surgeon specifies otherwise; other concurrent procedures follow the surgeon-selected plan and may be more protective.
- Return to activity is criteria-based and guided by soft-tissue healing, your progress, and physician clearance. Follow your operative note and surgeon's instructions, and use only the protocol you are given.
If your tenodesis was combined with another procedure, or was a revision
This protocol applies to an isolated primary biceps tenodesis. When a biceps tenodesis is performed together with a rotator-cuff repair, rehabilitation follows the applicable rotator-cuff repair protocol unless the surgeon specifies otherwise. Other concurrent procedures — such as a labral repair or a shoulder stabilization — follow the surgeon-selected plan and may require different or more protective restrictions. A tenotomy, revision, reconstruction, fixation failure, or fracture is not covered here. This protocol never substitutes for your operative note or the plan your surgeon selected — follow the individualized instructions your surgical team gives you.
How rehabilitation is generally structured
Rehabilitation after this procedure is usually organized into progressive phases. The phases below describe the general shape only — specific exercises, precautions, and timelines are individual and are set by your surgeon and physical therapist.
Period of protection
The earliest period after surgery, focused on protecting the tenodesis, controlling pain and swelling, and allowing only the gentle motion your surgeon permits — with no active loading of the biceps.
Early protected motion
Gradually restoring shoulder motion within the limits your surgeon sets, while the tenodesis continues to be protected and the biceps is not yet actively strengthened.
Active motion and early strengthening
Progressing toward full, comfortable motion and beginning strengthening as healing allows, with biceps loading introduced later in a staged way.
Return to activity
A criteria-based progression toward functional and, when appropriate, sport- or work-specific activity, guided by soft-tissue healing, your progress, and physician clearance rather than a fixed calendar.
This overview describes the general structure of rehabilitation only. It does not replace the specific instructions of your own surgeon and physical therapist, whose guidance always takes precedence. Timelines and precautions are individual and are set for you at your appointments. Use only the protocol your surgical team selected for you.